POSTSTREPTOCOCCAL REACTIVE ARTHRITIS, CLINICAL COURSE, AND OUTCOME IN6 ADULT PATIENTS

Objective. To analyze the clinical course and laboratory features, as well as the outcome of 6 adult patients with articular manifestations, and evidence of streptococcal infection. Methods. A retrospective rev iew was performed of all patients seen in a rheumatology clinic at Lou isiana State University Medical Center, with a diagnosis of poststrept ococcal reactive arthritis (PSReA) to summarize the clinical features, laboratory findings, and clinical outcome between July 1991 and Augus t 1994. Results. Six patients were identified with PSReA. All had acut e, severe inflammatory articular involvement that began shortly after a sore throat, with serological evidence of streptococcal infection, a nd accompanied by extraarticular clinical manifestations including glu merulonephritis and vasculitis, and poor response to aspirin and other nonsteroidal antiinflammatory drugs. In all cases the echocardiogram was negative, and on followup there was no evidence of cardiac involve ment. In these patients antibiotic prophylaxis was not required.Conclu sion. The clinical picture and serologic abnormalities exhibited by th is group of patients suggest a diagnosis of PSReA rather than acute rh eumatic fever. These cases also emphasize the resurgence of poststrept ococcal infection related articular manifestations in our clinic popul ation.